In outpatient clinics, patients with persistent throat disease often present with a foreign body in the throat, an obstructive sensation, or a cough that has not been cured for a long time, and no abnormalities are found on chest radiographs. The clinician only gives medication for laryngitis or cough, but the results are not effective. This is the time to be highly alert for the presence of pharyngeal reflux. According to statistics, 10% of patients attending otorhinolaryngology clinics have reflux-related laryngeal disease, which is mainly manifested by persistent hoarseness/poor vocalization (92%), foreign body sensation in the larynx (50%), and chronic cough (40%).
The main clinical manifestations are: persistent hoarseness/vocal dysphonia (92%), laryngeal foreign body sensation (50%), chronic cough (40%), pharyngeal foreign body sensation (33%), dysphagia (27%), and more than half of patients deny heartburn. Under normal physiological conditions, the mechanisms of resistance to acid reflux include the lower esophageal sphincter, the transverse septal pedicle, the esophageal body, and the esophagus.
In normal physiological state, the mechanisms of resistance to acid reflux include the lower esophageal sphincter, transverse septal foot, peristalsis of the body of the esophagus, upper esophageal sphincter and upper esophageal reflex. The lower esophageal sphincter and upper esophageal sphincter are the most important components of the anti-reflux barrier. Under normal conditions, the lower esophageal sphincter and upper esophageal sphincter are high-pressure areas,
During swallowing, the lower esophageal sphincter and upper esophageal sphincter are high-pressure areas, and they relax transiently to allow food to enter the stomach, and after swallowing, the lower and upper esophageal sphincters remain high-pressure,
The lower esophageal sphincter and upper esophageal sphincter maintain high pressure after swallowing to prevent regurgitation of stomach contents into the esophagus and pharynx. If the stomach contents reflux through the esophagus to the throat caused by the injury is called pharyngeal reflux. Second, how to diagnose pharyngeal reflux mainly includes electronic laryngoscopy, 24-hour PH monitoring, esophageal manometry esophagogram and diagnostic treatment. Among them,
24-hour PH monitoring is the gold standard for the diagnosis of pharyngeal reflux. Erythema of the arytenoid cartilage, interarytenoid region and epiglottis surface, cobblestone appearance of the interarytenoid region, vocal fold edema, vocal fold granuloma and contact ulcers can be seen under electrolaryngoscopy,
The accumulation of subglottic secretions. How to treat pharyngeal reflux ①Improve eating habits: 3 h before going to bed
Do not eat too much, do not lie down immediately after meals; low-fat diet, avoid fried foods; do not drink coffee, tea and soda drinks, do not eat chocolate, mint; avoid caffeinated food and drinks; abstain from alcohol. ②Improve your lifestyle: elevate your head 10-15 cm during sleep.
(when there is nocturnal reflux); avoid wearing tight clothing; quit smoking. ③Medication: use proton pump inhibitor omeprazole. ④Severe pharyngeal reflux should be treated surgically.